Gürdoğan Muhammet, Kehaya Sezgin, Korkmaz Selçuk, Altay Servet, Özkan Uğur, Kaya Çağlar
Department of Cardiology, School of Medicine, Trakya University, 22030 Edirne, Turkey.
Department of Neurology, School of Medicine, Trakya University, 22030 Edirne, Turkey.
Medicina (Kaunas). 2019 Feb 4;55(2):38. doi: 10.3390/medicina55020038.
Cranial magnetic resonance imaging findings of patients considered to be cryptogenic stroke may be useful in determining the clinical and prognostic significance of arrhythmias, such as atrial premature beats and atrial run attacks, that are frequently encountered in rhythm Holter analysis. This study was conducted to investigate the relationship between short atrial runs and frequent premature atrial contractions detected in Holter monitors and infarct distributions in cranial magnetic resonance imaging of patients diagnosed with cryptogenic stroke.
We enrolled the patients with acute ischemic stroke whose etiology were undetermined. We divided the patients in two groups according to diffusion-weighted magnetic resonance imaging as single or multiple vascular territory acute infarcts. The demographic, clinical, laboratory, echocardiographic, and rhythm Holter analyses were compared.
The study investigated 106 patients diagnosed with cryptogenic stroke. Acute cerebral infarctions were detected in 31% of the investigated patients in multiple territories and in 69% in a single territory. In multivariate logistic regression analysis, the total premature atrial contraction count (OR = 1.002, 95% CI: 1.001⁻1.004, p = 0.001) and short atrial run count (OR = 1.086, 95% CI: 1.021⁻1.155, p = 0.008) were found as independent variables that could distinguish between infarctions in a single or in multiple vascular territories.
Rhythm Holter monitoring of patients with infarcts detected in multiple vascular territories showed significantly higher premature atrial contractions and short atrial run attacks. More effort should be devoted to the identification of cardioembolic etiology in cryptogenic stroke patients with concurrent acute infarcts in the multiple vascular territories of the brain.
对于被认为是隐源性卒中的患者，其头颅磁共振成像（MRI）结果可能有助于确定心律失常（如心房早搏和房性心动过速发作）的临床及预后意义，这些心律失常在动态心电图分析中经常出现。本研究旨在探讨动态心电图监测中检测到的短阵房性心动过速和频发房性早搏与隐源性卒中患者头颅MRI梗死灶分布之间的关系。
我们纳入了病因未明的急性缺血性卒中患者。根据扩散加权磁共振成像将患者分为两组，即单血管区域急性梗死和多血管区域急性梗死。比较了两组患者的人口统计学、临床、实验室、超声心动图及动态心电图分析结果。
该研究共调查了106例诊断为隐源性卒中的患者。在被调查患者中，31%在多个区域检测到急性脑梗死，69%在单个区域检测到。在多因素逻辑回归分析中，发现总的房性早搏计数（OR = 1.002，95%CI：1.001⁻1.004，p = 0.001）和短阵房性心动过速计数（OR = 1.086，95%CI：1.021⁻1.155，p = 0.008）是可区分单血管区域梗死和多血管区域梗死的独立变量。
对在多个血管区域检测到梗死灶的患者进行动态心电图监测显示，房性早搏和短阵房性心动过速发作明显更多。对于在脑多个血管区域同时发生急性梗死的隐源性卒中患者，应更加努力地识别心源性栓塞病因。
